Microsurgical fronto-temporal approach to pituitary adenomas with extrasellar extension.

In the present paper the microsurgical, fronto-temporal technique for the surgical treatment of chromophobe pituitary adenomas with extra-seller extension is described in detail. The complete treatment of expansive chromophobe adenomas includes 4000 rad of external irradiation by the rotation technique and hormonal replacement therapy. The results of this treatment in 36 consecutive patients from 1971 through 1975 are given. There is no mortality nor recurrence of tumor in the follow-up period. The postoperative morbidity is low, especially in the group operated by the microsurgical fronto-temporal approach. The visual acuity improved or normalized in 86%, for the visual fields this percentage was 90%. These results are compared to those of our own series of 65 patients, treated from 1945 through 1959, and to some other data from the literature. Finally, some arguments in favour of the intracranial approach versus the transsphenoidal approach are presented.